Pathologies, Massage, and Contraindications Part 10 Pain – By Vanessa Ragains

In the previous week, we reviewed the importance of how Massage can support someone who has suffered a Stroke. Even though there are precautions Massage therapists must take, massage can be incredibly useful especially when complemented with occupational as well as Physical therapy. Our final Pathology post will be about Pain. We all have dealt with this in one way or another. Below are different scenarios of a client dealing with pain in specific areas, how to provide a beneficial massage, or if massage should be avoided until cleared from a Doctor.

Pathologies, Massage, and Contraindications Part 10 Pain

Definition of Pain: Physical suffering or discomfort caused by illness or injury.


  • Inflammation to injured area
  • Redness around the injured area
  • Hot to the touch
  • Bruised (depending on severity)
  • Cannot place pressure on specific area
  • Limited Range of Motion (ROM)

Massage Risks:

Joint Injury: Depending on the severity of the injury, the client may need a doctors note allowing your to work with the client. If this is not the case, massaging other areas can be helpful in relieving tension and other stressors the injury has caused the body.

Spinal Injury: Since spinal injuries can affect the nerve, cerebral spinal fluid, and communication to the brain, it is best to get a doctor’s note before working with your client. I would also suggest your client ask their doctor what type of bodywork is appropriate and where to avoid.

Muscle Injury: Similar to joint injuries, when a muscle is strained or torn it is best to suggest to your client to rest that area. We are taught in Massage school about RICE. I suggest the my clients do, what I like to call, a flush. You start with heat which brings blood flow and circulation to the area for 15 minutes, then I advise them to use ice. This can be repeated up to 3 times, but always ending with Ice.

Massage Benefits:

When working with clients who have injuries, it is always best to understand the situation before moving forward with body work. That said, I always advise the client to speak with their doctor to get cleared for Bodywork. This protects us from a liability situation in the future. Everyone has a different pain tolerance and many clients just want a massage, but are unable to see how this session could make the injury worse.

My opinion:

STICK TO YOUR GUNS! If the client is being demanding about getting their session, I will just keep repeating my words. I have had a couple instances where my client was unable to see the reasoning for my hesitation in massaging them. Once you throw the “Its a Liability for my career” line, I find that they begin to understand that their is a risk of making their situation much worse. Massage can be useful in light flushing of the inflamed area. This seems to be very helpful in eliminating fluid in the joint/area that makes it difficult to move with proper range of motion.

Is there a Pathology you would be interested in reading about? I would love your suggestions on certain pathologies that you may need to see in the breakdown. Check back next week for our next discussion on Pathologies, Massage, and Contraindications!

Thank you for taking time out of your day to read my blog. I am looking forward to reviewing common and uncommon Pathologies that we may encounter on our journey of being a Massage therapist. For all you awesome clients out there, I hope you learn why massage can actually be contraindicated with certain pathologies and precautions you and your therapist need to take.

I LOVE YOUR QUESTIONS!! Please feel free to ask me a question or comment about what you read today. Looking forward to hearing from radical Folks like yourself!


All this information come from one of my must-have books for the massage career: A Massage Therapist Guide to Pathology. 5th Edition Author: Ruth Werner



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